The possibility of a “single-payer” healthcare program has fallen off the table. I’m not sure exactly how or when this option became untenable, but it shows how quickly the efforts of pharmaceutical and insurance companies can reframe a discussion. After all, there are billions upon billions of dollars at stake, which is precisely why it is such a profound issue for our long-term fiscal health. It is not at all surprising that these companies are spending millions to defeat meaningful reform. The essential goal of this reform, after all, is to reduce the amount of money our nation spends on health care (while improving overall care). Which is not at all in the interest of these companies. What is astounding is that they are actually succeeding in derailing the discussion into lunacy.